POS1075 CROSS-SECTIONAL OBSERVATIONAL AND MULTICENTER STUDY FOR THE VALIDATION OF THE SPANISH VERSION OF THE PURE-4 QUESTIONNAIRE
Authors: R. Queiro Silva, I. Belinchón, A. Lopez-Ferrer, M. Ferran I Farrés, R. Rivera Díaz, D. Vidal Sarro, L. Rodriguez Freire, P. De la Cueva Dobao, J. Santos Juanes, V. Rocamora Duran, C. Sanabra, G. Guinea Uzábal, V. Martín Vázquez
Journal: Annals of the Rheumatic Diseases (2022)

Background The Psoriatic arthritis UnclutteRed screening Evaluation (PURE-4) has been culturally adapted to Spanish language recently following the standardized methodology. 1 A group of experts in psoriasis and psoriatic arthritis (PsA) has recently recommended the use of the Spanish version of PURE-4 due to the reduced number of items, its high sensitivity and specificity and the feasibility to implement in the clinical practice. Objectives To validate the Spanish version of the PURE-4 questionnaire. Methods Cross-sectional, observational and multicenter study conducted with primary data collection under conditions of routine clinical practice in Spain. The study included adult patients with diagnosis of psoriasis of any time of evolution and any type of severity, that voluntarily accepted to participate. Primary endpoint: validation of PURE-4 questionnaire in terms of sensitivity, specificity, feasibility, reliability (internal consistency) and construct validity. The study consists in two cross-sectional evaluations: assessment I (a visit performed by a dermatologist, followed by an independent visit to the rheumatologist within the following 4 weeks after to the dermatologist’s visit and scheduled according to routine clinical practice) and assessment II (patients without PsA in assessment I will be evaluated by the rheumatologist one year ±2 months later and the rheumatologist will perform the PsA diagnostic confirmation according to the rheumatologist criteria and will collect clinical characteristics). Since data from assessment II are not yet available, data from assessment I are presented. Results 268 evaluable patients included, 57.1% male, with a mean (SD) age of 47.1 (12.6) years, a mean (SD) time from diagnosis of 18.6 (12.9) years and mostly receiving psoriasis treatment (88.8%), biological treatment being the most common (43.3%). Mean (SD) PURE-4 score for all patients was 1.4 (1.3), being 2.3 (1.1) for patients with PsA and 1.3 (1.3) for patients without PsA diagnosis (Table 1). 268 (100.0%) patients answered the full PURE-4 questionnaire. Area under the receiver-operating characteristic (ROC) curve was 0.7185 (95% CI: 0.6391, 0.7978), showing good quality of fit or quality of the questionnaire (Figure 1). Using the Youden index, which determines the optimal cut-off point for the classification of patients, it was identified that a score ≥2 indicated a diagnosis of PsA. PURE-4 questionnaire showed a sensitivity of 77.1% and a specificity of 61.1%. Table 1. Sociodemographic and clinical baseline characteristics (assessment I) Characteristics With PsA diagnosis (n=35 ) Without PsA diagnosis (n=226 ) Not assesable (n=7 ) Total (n=268 ) Age, mean (SD) 50.5 (10.0) 46.5 (12.9) 49.9 (11.2) 47.1 (12.6) Female, n (%) 14 (40.0%) 97 (42.9%) 4 (57.1%) 115 (42.9%) Years since diagnosis, mean (SD) 19.7 (14.2) 18.3 (12.8) 22.4 (9.0) 18.6 (12.9) Current treatment for psoriasis, n (%) 32 (91.4%) 199 (88.1%) 7 (100.0%) 238 (88.8%) Phototherapy, n (%) 5 (15.6%) 16 (8.0%) 0 (0.0%) 21 (8.8%) Topic treatment, n (%) 20 (62.5%) 66 (33.2%) 3 (42.9%) 89 (37.4%) Conventional systemic no biological treatment, n (%) 7 (21.9%) 40 (20.1%) 2 (28.6%) 49 (20.6%) Biological treatment, n (%) 8 (25.0%) 91 (45.7%) 4 (57.1%) 103 (43.3%) Phosphodiesterase-4 inhibitors, n (%) 0 (0.0%) 8 (4.0%) 0 (0.0%) 8 (3.4%) Others, n (%) 0 (0.0%) 3 (1.5%) 0 (0.0%) 3 (1.3%) PASI, mean (SD) 8.7 (5.5) 7.0 (5.0) 4.2 (3.1) 7.2 (5.1) Mild (PASI&lt;7), n (%) 11 (31.4%) 95 (42.0%) 5 (71.4%) 111 (41.4%) Moderate/severe (PASI≥7), n (%) 24 (68.6%) 131 (58.0%) 2 (28.6%) 157 (58.6%) APs, psoriatic arthritis; PASI, Psoriasis Area and Severity Index ; SD, standard deviation. Figure 1. Area under the ROC curve (assessment I) Conclusion PURE-4 is a valid and compliant questionnaire with clinical practice in dermatology. It could be answered by patients in the waiting room and reviewed by dermatologists during the visit to support decision-making. PURE-4 could also help rheumatologists to early diagnose PsA patients in clinical practice. References [1]Actas Dermosifiliogr. 2020;111(8):655-64. Acknowledgements The authors thank IQVIA and Carmen Barrull, Neus Canal and Marco Pinel for providing medical editorial assistance with this presentation. Disclosure of Interests Rubén Queiro Silva Speakers bureau: AbbVie, MSD, Pfizer, Novartis, Lilly, Janssen, UCB y Celgene., Consultant of: AbbVie, MSD, Pfizer, Novartis, Lilly, Janssen, UCB y Celgene., Grant/research support from: Novartis, AbbVie y Janssen., Isabel Belinchón Speakers bureau: Janssen Pharmaceuticals Inc., Almirall, Lilly, AbbVie, Novartis, Celgene, Biogen Amgen, Leo-Pharma, Pfizer-Wyeth, UCB y MSD., Consultant of: Janssen Pharmaceuticals Inc., Almirall, Lilly, AbbVie, Novartis, Celgene, Biogen Amgen, Leo-Pharma, Pfizer-Wyeth, UCB y MSD., Anna Lopez-Ferrer Speakers bureau: Novartis, Janssen, MSD, Lilly, Pfizer,Celgene, Almirall, Leo Pharma, AbbVie y Amgen., Consultant of: Novartis, Janssen, MSD, Lilly, Pfizer,Celgene, Almirall, Leo Pharma, AbbVie y Amgen., Marta Ferran i Farrés Speakers bureau: Janssen, Lilly, Novartis, Pfizer, MSD, AbbVie, Celgene y Almirall., Paid instructor for: Janssen, Lilly, Novartis, Pfizer, MSD, AbbVie, Celgene y Almirall., Consultant of: Janssen, Lilly, Novartis, Pfizer, MSD, AbbVie, Celgene y Almirall., Raquel Rivera Díaz Speakers bureau: AbbVie, Almirall, Celgene Corporation, GSK, Janssen-Cilag, Lilly, LEO Pharma, MSD, Novartis, Pfizer y UCB., Paid instructor for: AbbVie, Almirall, Celgene Corporation, GSK, Janssen-Cilag, Lilly, LEO Pharma, MSD, Novartis, Pfizer y UCB., Consultant of: AbbVie, Almirall, Celgene Corporation, GSK, Janssen-Cilag, Lilly, LEO Pharma, MSD, Novartis, Pfizer y UCB., David Vidal Sarro Speakers bureau: Lilly, Janssen, AbbVie, Novartis, UCB, Celgene, Gebro y Leo., Paid instructor for: Lilly, Janssen, AbbVie, Novartis, UCB, Celgene, Gebro y Leo., Consultant of: Lilly, Janssen, AbbVie, Novartis, UCB, Celgene, Gebro y Leo., lourdes rodriguez freire Speakers bureau: AbbVie, Janssen Pharmaceuticals Inc., MSD, Pfizer-Wyeth, Novartis, Celgene, Almirall SA, Lilly y Leo-Pharma., Consultant of: AbbVie, Janssen Pharmaceuticals Inc., MSD, Pfizer-Wyeth, Novartis, Celgene, Almirall SA, Lilly y Leo-Pharma., Pablo de la Cueva Dobao Speakers bureau: AbbVie, Almirall, Amgen, Boehringer, Biogen, Celgene, Gebro, Janssen Cilag, Leo-Pharma, Lilly, MSD, Novartis, Pfizer- Wyeth, Sandoz, Sanofi y UCB., Paid instructor for: AbbVie, Almirall, Amgen, Boehringer, Biogen, Celgene, Gebro, Janssen Cilag, Leo-Pharma, Lilly, MSD, Novartis, Pfizer- Wyeth, Sandoz, Sanofi y UCB., Consultant of: AbbVie, Almirall, Amgen, Boehringer, Biogen, Celgene, Gebro, Janssen Cilag, Leo-Pharma, Lilly, MSD, Novartis, Pfizer- Wyeth, Sandoz, Sanofi y UCB., Jorge Santos Juanes Speakers bureau: Novartis, Lilly, Janssen, Abbvie, Amgen, y Sanofi., Consultant of: Novartis, Lilly, Janssen, Abbvie, Amgen, y Sanofi., Grant/research support from: Novartis, Lilly, Janssen, Abbvie, Amgen, y Sanofi., Vicenç Rocamora Duran Speakers bureau: Jansen, Lilly, Abbvie, Almirall, Amgen y Novartis., Paid instructor for: Jansen, Lilly, Abbvie, Almirall, Amgen y Novartis., Cristina Sanabra Employee of: Novartis Pharmaceuticals Spain, Guillermo Guinea Uzábal Employee of: Novartis Pharmaceuticals Spain, Víctor Martín Vázquez Employee of: Novartis Pharmaceuticals Spain